Acquired brain injuries in Aboriginal and Torres Strait Islander populations

• The incidence rate of stroke for Aboriginal and Torres Strait Islander Australians has been found to be 2.6 times higher for men and 3.0 for women (Australian Institute of Health and Welfare, 2008; Katzenellenbogan et al. 2010) compared to non-Aboriginal and Torres Strait Islander Australians and many suggest that these figures may in fact be underestimates (Thrift et al 2011).
• Aboriginal and Torres Strait Islander Australians are known to experience stroke at a younger age than their non-Aboriginal and Torres Strait Islander counterparts, (Katzenellenbogen et al., 2010; Australian Institute of Health and Welfare, 2004) with 60% of Aboriginal and Torres Strait Islander non-fatal stroke burden occurring in the 25-54 year age-group compared to 24% in the non-Aboriginal and Torres Strait Islander group (Katzenellenbogen et al., 2010).
• The prevalence of stroke is similarly significantly higher at younger ages among Aboriginal and Torres Strait Islander people (Katzenellenbogen 2013), with a significantly higher prevalence of co-morbidities among Aboriginal and Torres Strait Islander patients under 70 years of age, including heart failure, atrial fibrillation, chronic rheumatic heart disease, ischaemic heart disease, diabetes and chronic kidney disease. This reflects the increased clinical complexity among Aboriginal and Torres Strait Islander stroke patients compared with non-Aboriginal/Torres Strait Islander patients.
• Aboriginal and Torres Strait Islander stroke patients aged 18–64 years have a threefold chance of dying or being dependent at discharge compared to non-Aboriginal and Torres Strait Islander patients (Kilkenny et al., 2012).
• The overall rate of head injury due to assault in Aboriginal and Torres Strait Islander populations is up to 21 times higher than that among the non-Aboriginal and Torres Strait Islander population (Jamieson et al., 2008).
• The Epidemiology of Injury in Western Australia report (Department of Health Western Australia, 2011) concludes that Aboriginal people are much more likely than their non-Aboriginal counterparts to experience all the types of injuries which potentially result in brain damage including falls, motor vehicle accidents, drowning, poisoning, assault, and alcohol-related injuries.
• The limited research in these areas to date has largely focused on disease and disease prevention, so data are not available on the number of Aboriginal and Torres Strait Islander Australians with acquired communication disorders (ACD) following stroke or traumatic brain injury, or the short and long-term life outcomes for individuals surviving such conditions.
• The Aboriginal and Torres Strait Islander Health Performance Framework 2010 Report (Australian Health Ministers’ Advisory Council, 2011) states that “injuries can cause long-term disadvantage for Aboriginal and Torres Strait Islander peoples including: loss of cultural knowledge and wisdom, and the chance of a full life; the burden on caregivers for people with disabilities; decreased workplace productivity; and continuation of the cycle of grief among families, friends and communities” (p. 18)·      

References:

1. Australian Health Ministers’ Advisory Council (2011). Aboriginal and Torres Strait Islander Health Performance Framework Report 2010, AHMAC, Canberra.
2. Australian Institute of Health and Welfare (2004). Heart, stroke and vascular disease –    Australian facts 2004. Canberra: AIHW, 40.
3. Australian Institute of Health and Welfare (2008). Indigenous and Torres Strait Islander  Health Performance Framework report 2008: Detailed analyses. Canberra: AIHW
4. Dept of Health of Western Australia. (2011).  Epidemiology of Injury in Western Australia 2000-2008 Report. Perth, Australia: Dept of Health of Western Australia
5. Jamieson, L., Harrison, J. E., & Berry, J. G. (2008).  Hospitalisation for head injury due to assault among Indigenous and non-Indigenous Australians, July 1999 – June 2005. Medical Journal of Australia, 188(10), 576-579.
6. Katzenellenbogen, J. S., Vos, T., Somerford, P., Begg ,S., Semmens, J. B., & Coddie ,J.P. (2010). Burden of stroke in Indigenous Western Australians: A study using data linkage. Stroke, 42, 1515-1521.
7. Katzenellenbogen, J. M. et al (2013). The prevalence of stroke in Aboriginal and non-Aboriginal Western Australians: a study using data linkage. Stroke Society of Australasia Conference. Darwin July.
8. Kilkenny, M. F., Harris, D. M., Ritchie. D. A., Price. C.,& Cadhilac, D. A. (2012). Hospital management and outcomes of stroke in Indigenous Australians: evidence from the 2009 Acute Care National Stroke Audit. Int J Stroke; EPub 2012 Feb 2. doi: 10.1111/j.1747-4949.2011.00717.x.

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